Shape-adjustable surgical implement handle

ABSTRACT

A multi-purpose surgical implement handle has proximal and distal ends. A gripping section is located toward the proximal end, and an attachment section is located toward the distal end. An adjusting section is interposed between the gripping section and the attachment section. The adjusting section may be bent by a human user at virtually any discrete location along the section. The adjusting section may include an increased-adjustability portion which is easier to bend than other portions of the adjusting section.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application for the present invention is a continuation-in-partapplication of Ser. No. 08/865,628 filed May 29, 1997.

FIELD OF THE INVENTION

The present invention relates to a multi-purpose surgical implementhandle and particularly to a multi-purpose adjustable surgical implementhandle useful in procedures where the surgical incision is small,confining or torturous.

BACKGROUND OF THE INVENTION

Surgical patients today often desire operations be performed with theleast amount of intrusion into the body. Such minimally invasiveprocedures usually provide speedier recovery for the patient with lesspain and bodily trauma, thereby reducing the medical costs and theoverall disruption to the life of the patient. A minimally invasiveapproach also usually results in a smaller incision and, therefore, lessscarring, which is an aesthetic advantage attractive to most patients.

The use of a minimally invasive approach, however, introduces newcomplexities to surgery thus placing a greater burden on the operatingsurgeon. Most notably, minimally invasive approaches drastically reducethe size of the surgical field available to the surgeon for themanipulation of tissue and for the introduction of necessary surgicalinstruments, such as cutting devices, clamps, prosthetic holders, and soon.

The aforesaid complexities are especially acute in connection with heartsurgery. Unlike common heart surgeries performed using a full medialsternotomy, minimally invasive heart surgery offers a surgical fieldthat may be only as large as a resected intercostal space or atransversely cut and retracted sternum. Consequently, the introductionof tools, such as prosthetic sizing elements, valve holders,annuloplasty ring holders, and other such devices, becomes a great dealmore complicated.

The majority of instruments currently available to surgeons forperforming minimally invasive surgeries are devices designed for use infar less restrictive surgical fields. That is, the existing instrumentshave characteristics which are not conducive for use in restrictivesurgical fields. For example, in heart surgery, the majority ofimplements available to hold or retain various heart devices or tools(e.g., heart valves and annuloplasty rings) in a minimally invasiveprocedure either are too short to enable easy introduction of prosthesesto the target site and/or have shafts which lack the necessarymalleability or flexibility to enable proper orientation of theprostheses at the distal end of the shaft. Indeed, there are a number ofconventional handles with shafts that require an end load of 25 pounds(lbs.) or more to bend the shaft. Furthermore, many of the existingdevices have only one application, e.g., a handle for a valve-sizingtemplate or a handle for holding a prosthetic valve, thus requiring theintroduction of multiple tools into the surgical field. Examples of suchprior art devices are disclosed in U.S. Pat. No. 4,679,556 to Lubock etal.; U.S. Pat. No. 5,531,785 to Love et al.; U.S. Pat. No. 5,360,014 toSauter et al.; U.S. Pat. No. 5,403,305 to Sauter et al.; U.S. Pat. No.5,476,510 to Eberhardt et al.; U.S. Pat. No. 5,489,296 to Love et al.;and U.S. Pat. No. 5,560,487 to Starr.

SUMMARY OF THE INVENTION

It is therefore an object of the present invention to overcome theshortcomings of the prior art by providing a multi-purpose surgicalimplement handle that is especially useful in minimally invasivesurgical procedures.

It is a further object of the present invention to provide a surgicalimplement handle that has sufficient length to enable a surgeon toeasily place a heart device at a target site.

It is a further object of the present invention to provide a surgicalimplement handle with a malleable portion that is sufficiently flexibleto enable suitable orientation of the heart device for insertion in aminimally invasive procedure.

It is a further object of the present invention to provide a surgicalimplement handle that has multiple uses.

It is a further object of the present invention to provide a surgicalimplement handle that reduces the complexities of minimally invasiveprocedures.

It is a further object of the present invention to provide a surgicalimplement handle that is cost effective to produce.

These and other objects not specifically enumerated above are believedto be accomplished by a surgical implement handle according to thepresent invention wherein the handle includes a distal end and aproximal end. The handle has a gripping section located toward theproximal end and an attachment section located toward the distal end.The handle includes a malleable section interposed between the grippingsection and the attachment section. The malleable section issufficiently flexible to enable formation of a bend by a human user atsubstantially any discrete location along substantially the length ofthe malleable section.

According to another aspect of the invention, a shape-adjustable handleincludes a gripping section disposed on a proximal end thereof, anattaching section disposed on a distal end thereof, and an adjustingsection disposed between the gripping and attaching sections. Theadjusting section is bendable so that the attaching section ispositionable with respect to the gripping section. The attachmentsection may include a securing mechanism for engaging, either releasablyor permanently, with a surgical implement. The adjusting section mayinclude a main portion and an increased-adjustability portion which maybe more easily bent than the main portion. For example, a surgeon mayhold the gripping section in one hand and the attaching section in theother hand and may position a thumb at a discrete location along theincreased-adjustability portion. The surgeon may then urge either theattaching section or the gripping section about the thumb to form a bendin the increased-adjustability section.

To be more bendable than the main portion, the increased-adjustabilityportion may have a smaller diameter than the main portion.Alternatively, the increased-adjustability portion may be made frommaterial which is more malleable (or less stiff) than material fromwhich the main portion is made. In one embodiment in which the adjustingsection is tubular in cross section, the increased-adjustability portionmay have a smaller wall thickness than that of the main portion. As theadjusting section is made from material which is malleable and pliable,the adjusting section is sufficiently supple to bend repeatedly withoutbreaking or causing substantially material fatigue. The capacity of theshape-adjustable handle for adaptive change allows the handle to bereadjusted to various positions during surgical procedures.

BRIEF DESCRIPTION OF THE DRAWINGS

Numerous other features and attendant advantages of the presentinvention shall become apparent from reference to the followingdescription considered in conjunction with the accompanying drawings,wherein like reference numerals refer to like items and wherein:

FIG. 1 is a perspective view of a multi-purpose surgical implementhandle in accordance with the present invention;

FIG. 2 is a plan view of a multi-purpose surgical implement handle inaccordance with the present invention;

FIG. 3 is a perspective view of a multi-purpose surgical implementhandle in accordance with the present invention as it is being bent by auser;

FIG. 4 is a perspective view of a multi-purpose surgical implementhandle in accordance with the present invention as it is being bent by auser while the handle is holding a tool;

FIG. 5 is a plan view an attachment section useful on the multi-purposesurgical handle in accordance with the present invention;

FIG. 6 is a table of property characteristics of stainless steel as usedin a preferred embodiment of the multi-purpose surgical implement handlein accordance with the present invention;

FIG. 7A is a cross-sectional view taken along line 7--7 of FIG. 2 of thesurgical implement handle of the invention, illustrating a preferredembodiment of a malleable section of the handle;

FIG. 7B is a cross-sectional view similar to that of FIG. 7A,illustrating an alternative embodiment of the malleable section of thehandle;

FIG. 8 is a schematic view of a minimally invasive surgical procedure,illustrating a chest cavity in cross section and a shape-adjustablehandle of the invention extending through a surgical incision to atarget site;

FIG. 9 is a plan view of another embodiment of a shape-adjustable handleof the invention;

FIG. 10 is an enlarged plan view of the shape-adjustable handle of FIG.10, particularly illustrating an adjusting section including a mainportion and an increased-adjustability portion;

FIG. 11A is a cross-sectional view taken along line 11--11 of FIG. 10,illustrating an exemplary embodiment of the main portion of theadjusting section of the handle;

FIG. 11B is a cross-sectional view taken along line 11--11 of FIG. 10,illustrating another exemplary embodiment of the main portion of theadjusting section;

FIG. 11C is a cross-sectional view taken along line 11--11 of FIG. 10,illustrating yet another exemplary embodiment of the main portion of theadjusting section;

FIG. 11D is a cross-sectional view taken along line 11--11 of FIG. 10,illustrating still another exemplary embodiment of the main portion ofthe adjusting section;

FIG. 11E is a cross-sectional view taken along line 11--11 of FIG. 10,illustrating a further exemplary embodiment of the main portion of theadjusting section;

FIG. 12A is a cross-sectional view taken along line 12--12 of FIG. 10,illustrating an exemplary embodiment of the increased-adjustabilityportion of the adjusting section of the handle;

FIG. 12B is a cross-sectional view taken along line 12--12 of FIG. 10,illustrating another exemplary embodiment of the increased-adjustabilityportion of the adjusting section;

FIG. 12C is a cross-sectional view taken along line 12--12 of FIG. 10,illustrating yet another exemplary embodiment of theincreased-adjustability portion of the adjusting section;

FIG. 12D is a cross-sectional view taken along line 12--12 of FIG. 10,illustrating still another exemplary embodiment of theincreased-adjustability portion of the adjusting section;

FIG. 12E is a cross-sectional view taken along line 12--12 of FIG. 10,illustrating a further exemplary embodiment of theincreased-adjustability portion of the adjusting section;

FIG. 13 is a plan view of a yet another embodiment of a shape-adjustablehandle of the present invention;

FIG. 14 is a cross-sectional view taken along line 14--14 of FIG. 13,illustrating a main portion of an adjusting section of the handle; and

FIG. 15 is a cross-sectional view taken along line 15--15 of FIG. 13,illustrating an increased-adjustability portion of the adjusting sectionof the handle.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Referring to the drawing figures, and particularly FIGS. 1 and 2, apreferred embodiment of the present invention includes a handle 100having a gripping section 102 at its proximal end, an attachment section106 at its distal end and a malleable section 104 disposed therebetween.The handle 100 is useful for holding not only a sizing template 107 fora cardiac mitral valve but for holding any other device, e.g., aprosthetic valve sizer, a prosthetic valve, etc., as well. As such, thehandle 100 is a multi-purpose tool.

The gripping section 102 has a tapered contour, narrowing from itswidest portion at the proximal end of the handle 100 to its narrowestportion toward the distal end of the handle 100. The attachment section106 is of a substantially cylindrical construction and includes a thinflat flange section 112 disposed adjacent to an externally threadedsection 108 toward the distal end of the handle 100. Referring to FIG.5, in an alternative embodiment, the attachment section 106 may includea conical shaped section 109 disposed adjacent to the externallythreaded section 108. In addition, the attachment section 106 mayinclude a circular protruding knob 110 which serves as the tip of thedistal end of the handle 100.

Both the gripping section 102 and the attachment section 106 may befabricated as an injection molded piece from a commonly known plastic orresin. In one embodiment, the external threads 108 are a 10-24 sizethread, although other thread sizes are also contemplated. As will beappreciated, any device being held by the handle 100 will need internalthreads of a type that will mate with the external threads 108 of theattachment section 106. It is further appreciated that the attachmentsection 106 may include internal, rather than external, threads and thatany device being held by the handle 100 would, thus, have correspondingand complementary external threads.

The protruding knob 110 has a known function of use with at leastcertain prosthetic mitral valves manufactured by Baxter HealthcareCorporation. The protrusion 110 serves to exert compressive pressure ina known manner on the prosthetic mitral valve when the valve is mountedin its holder to protect leaflets of the valve while the valve is beingtransported to the target surgical site.

Referring to FIGS. 3 and 4, the malleable section 104 of the handle 100is a wire that is sufficiently malleable or flexible to enable thesurgeon to easily bend the malleable section 104 at virtually anydiscrete location along substantially the length of the malleablesection 104, and especially very near the flange section 112 of theattachment section 106 and/or very near the gripping section 102.Moreover, as seen in FIG. 4, the malleable section 104 may be bent evenwhile a tool such as a sizing template 107 is connected to the handle.

Referring to FIGS. 3 and 4, in one preferred embodiment, the wire issufficiently flexible to enable the formation of a bend at a distance Efrom the attachment section 106 or the gripping section 102 (not shown)of approximately 0.197 inch (0.5 cm) or less. Such a wire also has adiameter within a range of 0.010 inch to 0.100 inch.

The malleable section 104 is not so flexible, however, as to be deformedor bent simply from the weight of the device being held by the handle orby inadvertent contact with peripheral objects during the surgicalprocedure. More specifically, the load required to bend the section 104at a distance E of approximately 0.197 inch (0.5 cm) or less ranges fromapproximately 5 lbs. to approximately 10 lbs.

The malleable section 104 may be of either solid construction, as shownin FIG. 7A, or hollow construction, as shown in FIG. 7B. However,whether hollow or solid, the malleable section 104 must retain theflexibility as described.

In one preferred embodiment, the malleable section 104 is formed of asolid stainless steel wire approximately 0.050 inch in diameter from atype 302 or 303 annealed stainless-steel wire. The properties of suchwire are listed in the table of FIG. 6. The load required to bend thewire at a distance E of approximately 0.197 inch (0.5 cm) from theflange is approximately 5.2 lbs. to 8.9 lbs.

Other materials, such as "memory" metals may also be suitable for themalleable section 104. Memory metals offer the additional advantage ofreturning to its original shape during the sterilization process. Onesuch memory metal that is contemplated is a nickel-titanium alloy knownas NITINOL.

The handle 100 incorporating the above-described malleable section 104enables the surgeon to orient the device retained by the attachmentdevice 106 in a manner that uses the least amount of space. For example,if it is desired to orient a prosthetic valve such that the valve may beinserted through a small incision and, at the same time, be properlyoriented for attachment at the target site, the surgeon may do so byachieving a desired bend very near the attachment section 106 in themanner depicted in FIGS. 3 and 4. The resulting configuration enablesthe surgeon to introduce the valve through a small opening and avoidfurther manipulation of the handle while placing the valve at the targetsite.

Referring to FIG. 2, the overall length of the handle 100 is a length Aequal to approximately 10 inches. Of the 10 inches, the gripping portion102 has a length B of approximately 5 inches and the attachment section106 has a length D of approximately 0.5 inch. As a result, the exposedlength of the malleable section 104 has a length C of approximately 4.5inches. It will be appreciated, however, that the wire forming themalleable section 104 is longer than the exposed length C because thewire may extend a distance into the gripping section 102 and into theattachment section 106.

Referencing FIG. 8, the length of the handle 100 must be sufficient toenable a surgeon to place the end of the handle through a surgicalopening 114 and to a target site 116 in, for example, a chest cavity118, and, at the same time, comfortably and adequately hold the grippingportion 102 of the handle. That is, the handle 100 must be of sufficientlength so that the surgeon may grip the handle from above the chestopening 114 while the end of the handle is located at the target site116 within the chest cavity 118.

It is further desired that the portion of the handle actually extendingthrough the surgical incision and into the surgical field be themalleable section 104. This is desired as the malleable section 104 hasa diameter substantially less than the gripping section 102 and, thus,the malleable section 104 affords less obstruction of the surgicalfield. In this regard, in a preferred embodiment, the malleable section104 has a diameter of approximately 0.050 inch and the gripping sectionhas a diameter of approximately 0.312 inch at the point where thegripping section 102 ends and the malleable section 104 begins.Therefore, in a preferred embodiment, the ratio of the diameter of themalleable section 104 to the smallest diameter of the gripping portion102 is approximately 1 to 6.

A preferred embodiment of a shape-adjustable handle 120 is illustratedin FIG. 9. The handle 120 includes a gripping section 122 disposed on aproximal end thereof, an attaching section 124 disposed on a distal endthereof, and an adjusting section 126 disposed between the gripping andattaching sections 122, 124. The adjusting section 126 is bendable sothat the attaching section 124 is positionable with respect to thegripping section 122, much like that shown in FIGS. 3 and 4. Theattachment section 124 may include a securing mechanism 128 forengaging, either releasably or permanently, with a surgical implement.For example, as shown in FIG. 9, various interchangeable surgicalimplements may be threaded onto and off from the securing mechanism 128to provide a multi-purpose surgical tool.

With additional reference to FIG. 10, the adjusting section 126 of theexemplary handle 120 may include a main portion 130 and anincreased-adjustability portion 132. In accordance with the presentinvention, the increased-adjustability portion 132 is more bendable thanthe main portion 130; that is, a bend may be more easily formed in theincreased-adjustability portion 132 than in the main portion 130. Theadjusting section 126 of the handle 120 may also include a transitionportion 134 disposed between the main portion 130 and theincreased-adjustability portion 132, which will be discussed in moredetail below. Although other configurations are contemplated, theexemplary embodiment illustrated in FIG. 10 shows theincreased-adjustability portion 132 disposed distal to the main portion130 and adjacent to the attaching section 124.

Although the handle 120 may be configured according to any desiredspecification, dimensions of an exemplary commercial embodiment of thehandle 120 may include an overall length of about 15 cm to about 40 cm,a length of the gripping section 122 of about 7 cm to about 15 cm, alength of the attaching section 126 of about 1 cm to about 3 cm, and alength of the adjusting section 126 of about 10 cm to about 20 cm.Commercial dimensions of the adjusting section 126 may include a lengthof the main portion 130 of about 10 cm to about 15 cm, a length of theincreased-adjustability portion 132 of about 2 cm to about 5 cm, and alength of the transition portion 134 of about 0.5 cm to about 1 cm.

The higher bendability of the increased-adjustability portion 132provides surgeons with a high-leverage, stress-focusing "neck" portionof the shape-adjustable handle 120. For example, either with or withoutan implement in place on the attaching section 124, a surgeon may holdthe gripping section 122 in one hand and the attaching section 124 inthe other hand and may position a thumb at a discrete location along theincreased-adjustability portion 132 (to provide a fulcrum). The surgeonmay then urge the attaching section 124 about the thumb to form a bendin the increased-adjustability portion 132. Alternatively, the surgeonmay urge the gripping section 122 (and the main portion 130) about thethumb to form a bend in the increased-adjustability section 132. Ineither case, because the increased-adjustability portion 132 is morebendable than the main portion 130 (by being, for example, less stiff ormore malleable, which will be discussed in more detail below), theadjusting section 126 will be biased, predisposed, or more likely tobend at the increased-adjustability portion 132 thereof.

If it is desired to form a bend along the main portion 130, eithersingularly or in addition to any bend formed in theincreased-adjustability portion 132, a surgeon may position a fulcrum(such as his or her thumbs) at a desired location along the main portion130 and urge the main portion 130 about the fulcrum. Regardless of thelocation of the bend or bends formed along the adjusting section 126,the attaching section 124 is positionable and adjustable with respect tothe gripping section 122.

The adjusting section 126 may be made from material which is malleableand pliable. The material of the adjusting section 126 may also besufficiently supple to bend repeatedly without breaking or causingsubstantially material fatigue. The shape-adjustable handle's capacityfor adaptive change allows the handle to be readjusted to variouspositions during surgical procedures.

FIGS. 11A to 11E and 12A to 12E illustrate exemplary embodiments of theadjusting section 126 which provide the increased-adjustability portion132 with greater flexibility, bendability, or malleability than the mainportion. In FIGS. 11A and 12A, the adjusting section 126 is shown to besubstantially cylindrical, with the main portion 130 having a diameter Dlarger than a diameter d of the increased-adjustability portion 132. Forexample, diameter D of the main portion 130 may be about 2 mm to 3 mm,and diameter d of the increased-adjustability portion 132 may be about 1mm to 2 mm; in a commercial embodiment of the invention, diameter D maybe about 2.3 mm and diameter d may be about 1.8 mm. In this embodimentof the handle 120, the transition portion 134 may be tapered, conical,or frustum-shaped between portions 130 and 132. Also, the main portion130 and the increased-adjustability portion 132 may be substantiallycoaxial with each other.

The adjusting section 126 illustrated in FIGS. 11A and 12A is shown tobe substantially unitary in construction and made from a solid piece ofmalleable material. In the alternative embodiment shown in FIGS. 11B and12B, the adjusting section 126 may be made from a tubular piece ofmalleable material. In the tubular embodiment of the adjusting section126, to ensure that the increased-adjustability portion 132 is morebendable or flexible than the main portion 120, theincreased-adjustability section 132 may have either a diameter d lessthan a diameter D of the main portion 130, a wall thickness t less thana wall thickness T of the main portion 130 (and substantially equaldiameters), or a combination of a smaller diameter and a thinner wall.The tubular adjusting section 126 may be formed by extrusion or molding.

Referencing FIGS. 11C and 12C, the adjusting section 126 of the handle120 may include multiple layers of malleable material to provideportions 130 and 132 with differing malleability. For example, a centralcore 136 may extend the length of the adjusting section 126, and asleeve 138 may extend along only a portion of the adjusting section 126,substantially defining the main portion 130. The core 136 may be madefrom material having a malleability desired for theincreased-adjustability portion 132, while the sleeve 138 may be madefrom material having less malleability (or greater stiffness) than thatof the core 136. As shown in FIG. 11C, the core 136 and the sleeve 138may be substantially concentrically aligned.

In addition to the circular or cylindrical embodiments discussed above,the adjusting portion 126 may include a plurality of cross-sectionalconfigurations, including elliptical or oval, as shown in FIGS. 11D and12D, and rectilinear, as shown in FIGS. 11E and 12E. In thecross-sectional elliptical embodiment of the invention shown in FIGS.11D and 12D, the adjusting section 126 is more bendable about the minordiameter thereof than about the major diameter thereof. Accordingly, theadjusting section 126 may be biased to be bendable about desired axes.In this regard, the adjusting section 126 may be scored or may includepre-creased segments (not shown) to facilitate or to control bending ata predetermined location(s) along the length of the adjusting section126.

FIG. 13 illustrates an alternative embodiment of an adjustable handle140 in accordance with the invention. Similar to the handles describedabove, exemplary handle 140 includes a gripping section 142, anattaching section 144, and an interdisposed adjusting section 146. Theadjusting section 146 includes a main portion 148 and anincreased-adjustability portion 150. The adjusting section 146 is madefrom malleable material and is configured such that theincreased-adjustability portion 150 has a higher malleability than themain portion 148. Accordingly, the increased-adjustability portion 150is easier to bend than the main portion 148. The increased-adjustabilityportion 150 may also induce the formation of a bend having a smallradius of curvature. That is, bends with relatively small radii ofcurvature may be formed along the increased-adjustability portion 150 inan easier manner than along the main portion 148.

As shown in FIG. 13, rather than disposing the increased-adjustabilityportion 150 distal to the main portion 148 or adjacent to the attachingsection 144, the adjusting section 146 of the exemplary handle 140 isconfigured with the increased-adjustability portion 150 interposedwithin the main portion 148. Referencing FIGS. 14 and 15, the mainportion 148 has a diameter D, and the increased-adjustability portion150 has a diameter d. To provide portions with different bendingmoments, diameter D may be greater than diameter d. Alternatively, thediameters D and d may be substantially equal, and the main portion 148may be made from material having less malleability (or greaterstiffness) than material from which the increased-adjustability portion150 is made. The adjusting section 146 may be a unitary construction,or, alternatively, each of the portions 148 and 150 may be a separatepiece of material connected together to form the adjusting section 146.The separate portions may be fused or molded together or may bemechanically attached. In this regard, threading or other fasteningstructure may be provided to engage or connect the portions 148 and 150.

Those skilled in the art will recognize that the invention may beembodied in other specific forms without departing from the spirit oressential characteristics thereof. For example, rather than being madefrom malleable material, the adjusting portion 126 may be comprised of aplurality of articulated sections connected by pivoting joints and acable. In this configuration, the adjusting portion 126 may be bend asdesired and then the cable may be tensioned to hold the articulatedsections in place. The foregoing is intended, therefore, to beillustrative and not restrictive, and the scope of the invention isdefined by the following claims. All versions which are equivalent tothe claims are therefore intended to be embraced by such claims.

What is claimed is:
 1. A handle for holding an implement, comprising:agripping section; an attaching section to which The implement ismountable; and an adjusting section disposed between said grippingsection and said attachment section, said adjusting section beingbendable to allow said attachment section to be positioned with respectto said gripping section; said adjusting section including a mainportion and an increased-adjustability portion, saidincreased-adjustability portion being more bendable than said mainportion, and wherein said adjusting section is re-adjustable such thatmultiple bends are formable therein.
 2. A handle as set forth in claim1, wherein said adjusting section is made from malleable material;saidincreased-adjustability portion having a higher malleability than saidmain portion.
 3. A handle as set forth in claim 1, wherein saidincreased-adjustability portion has smaller physical dimensions thansaid main portion.
 4. A handle as set forth in claim 3, wherein saidadjusting section is cylindrical;said main portion and saidincreased-adjustability portion each having a diameter, said diameter ofsaid increased-adjustability portion being less than said diameter ofsaid main portion.
 5. A handle as set forth in claim 3, wherein saidadjusting section is tubular;said main portion and saidincreased-adjustability portion each having a wall thickness, said wallthickness of said increased-adjustability portion being less than saidwall thickness of said main portion.
 6. A handle as set forth in claim1, wherein said increased-adjustability portion is adjacent to saidattachment section.
 7. A handle as set forth in claim 1, wherein atleast one of said portions of said adjustable section is solid.
 8. Ahandle as set forth in claim 1, wherein at least one of said portions ofsaid adjustable section is tubular.
 9. A handle as set forth in claim 1,wherein said main portion and said increased-adjustability portion aresubstantially coaxial.
 10. A handle as set forth in claim 1, whereinsaid adjusting section further includes a transition portion disposedbetween said main portion and said increased-adjustability portion. 11.A handle as set forth in claim 10, wherein said adjusting section iscylindrical;said main portion and said increased-adjustability portioneach having a diameter, said diameter of said increased-adjustabilityportion being less than said diameter of said main portion; and saidtransition portion being conical.
 12. A handle as set forth in claim 11,wherein said adjusting portion is unitarily solid.
 13. A handle as setforth in claim 1, wherein said attachment section includes a securingmechanism for releasably engaging with a surgical implement.
 14. Ahandle as set forth in claim 1, wherein said adjusting section has anon-circular cross-section.
 15. A handle as set forth in claim 14,wherein said non-circular cross-section is more flexible about at leastone bending plane at least one other bending plane.
 16. A handle as setforth in claim 15, wherein said adjusting section has an ellipticalcross-section.
 17. A handle for holding an implement, comprising:agripping section; an attaching section to which the implement ismountable; and and adjusting section disposed between said grippingsection and said attachment section, said adjusting section beingbendable to allow said attachment section to be positioned with respectto said gripping section; said adjusting section including a mainportion and an increased-adjustability portion, saidincreased-adjustability portion being more bendable than said mainportion, and wherein said adjusting section further includes atransition portion disposed between said main portion and said increasedadjustability portion.
 18. A handle as set forth in claim 17, whereinsaid adjusting section is cylindrical;said main portion and saidincreased-adjustability portion each having a diameter said diameter ofsaid increased-adjustability portion being less than said diameter ofsaid main portion; and said transition portion being conical.
 19. Ahandle as set forth in claim 18, wherein said adjusting portion isunitarily solid.
 20. A handle as set forth in claim 17, wherein saidadjusting section is made from a malleable material;saidincreased-adjustability portion having a higher malleability than saidmain portion.
 21. A handle as set forth in claim 17, wherein saidadjusting section is tubular;said main portion and saidincreased-adjustability portion each having a wall thickness, said wallthickness of said increased-adjustability portion being less than saidwall thickness of said main portion.
 22. A handle as set forth in claim17, wherein said increased-adjustability portion is adjacent to saidattachment section.
 23. A handle as set forth is claim 17, wherein atleast one of said portions of said adjustable section is solid.
 24. Ahandle as set forth in claim 17, wherein at least one of said portionsof said adjustable section is tubular.
 25. A handle as set forth inclaim 17, wherein said main portion and said increased-adjustabilityportion are substantially coaxial.
 26. A handle as set forth in claim17, wherein said adjusting section has a non-circular cross-section. 27.A handle as set forth in claim 26, wherein said non-circular crosssection is more flexible about at least one bending plane than at leastone other bending plane.
 28. A handle as set forth in claim 27, whereinsaid adjusting section has an elliptical cross-section.